A rise in fentanyl use and the Covid-19 pandemic are thought to be responsible for a dramatic increase in overdose deaths from May 2020 through April 2021

100,000 Americans died in one year from a disease we can treat

Updated 1613 GMT (0013 HKT) November 19, 2021

(CNN)While the US has been in the throes of the Covid-19 pandemic, another public health crisis has surged past a tragic milestone. Over 100,000 people died from drug overdoses between May 2020 and April 2021, according to provisional data released by the US Centers for Disease Control and Prevention on Wednesday -- a 28.5% increase from the 12 months prior and a record high for the US.

Though these statistics are new, the problem is not. Overdose deaths have been trending upward for years.
A key aspect of the issue, experts say, has been the rise of fentanyl, a synthetic opioid that can be up to 100 times more potent than morphine, is much cheaper to produce than traditional plant-based opioids and is often mixed with street drugs without the buyer's knowledge, increasing the risk of a fatal overdose.
Combine the growing popularity of fentanyl with a pandemic that has forced people into isolation, and stripped them of the in-person relationships and support systems they depend on, and it's easy to understand the spike in overdose deaths since lockdowns began.
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But despite the macabre picture the trend lines paint, there is much that can be done to curb the overdose death rate, says CNN Medical Analyst Dr. Leana Wen, who served as the health commissioner of Baltimore from 2014 to 2018 during which time the city had some of the highest opioid overdose rates in the US, and who currently serves as advisory board chair of the Behavioral Health Group, a network of outpatient opioid treatment and recovery centers in the US.
Many of the programs Wen implemented in Baltimore -- including promoting the widespread availability of naloxone, the fast-acting opioid antidote, piloting test strips that can alert users to the presence of fentanyl in street drugs and increasing treatment for opioid use disorders -- she feels have the potential to curb overdose deaths across the nation.
To address the opioid crisis we must refocus on a single mission, says Wen, and remind ourselves that when it comes to public health, we are all striving for the same outcome: saving lives.
The following interview has been edited for length and clarity.
CNN: Experts have attributed the recent spike in overdose deaths to the pandemic and to the rise of fentanyl. Can you explain how those two factors impacted the overdose death rate?
Wen: Prior to the pandemic, we were already having an epidemic of opioid overdoses that was driven primarily by fentanyl, which is many times stronger than heroin and is often used to cut street drugs. So, if someone is taking their usual amount of heroin, for instance, but there's something in there that's many times stronger, they are much more likely to overdose and die.
And then the pandemic happened. Public health resources were already stretched to the limits, so the people working on the opioid crisis had to shift focus to addressing the pandemic. This was necessary, but it also left a gaping hole in the social safety net.
On top of that, we know that addiction is a disease of isolation, and recovery depends on relationships. Many people during the pandemic lost their health insurance and the ability to get treatment. Some may have lost other social resources like stable housing or faced food insecurity. Treating their disease of addiction may not have been top of mind. We also can't forget that addiction and mental health issues are diseases of despair, and this pandemic has worsened mental health for so many people. I think that is yet another layered component of what was already a major problem that has lost attention and lost funding and lost people working to solve it.
CNN: How can overdose deaths be addressed while the pandemic is still ongoing and resources are still stretched thin?
Wen: We can save lives right now through harm reduction practices. That includes getting naloxone, the opioid antidote, to as many people as possible in communities. We should also look at other classic harm reduction practices like making fentanyl test strips widely available. This does not mean condoning or encouraging drug use, but rather if people are going to be using drugs, they need to know if there's fentanyl in their supply so that they can reduce the risk of a fatal overdose. Then there are safe injection facilities, which in Portugal and the other countries have been shown to save lives. They are controversial, but if our focus is going to be on preventing deaths, then we should be looking at all strategies that are effective.
We also need to ensure that people have access to evidence-based treatment. For treating individuals with opioid use disorder, for instance, that means a combination of medications like buprenorphine or methadone, along with psychosocial support. There needs to be adequate insurance coverage for these treatments -- and while telemedicine should be enabled and allowed, we also must also recognize that many patients need brick and mortar care. Ultimately, the tre